Estimating preferences for a dermatology consultation using Best-Worst Scaling: comparison of various methods of analysis.
Estimating preferences for a dermatology consultation using Best-Worst Scaling: comparison of various methods of analysis.
复制标题
DOI：
10.1186/1471-2288-8-76
复制
发表时间：
2008-11-18
影响因子：
4
通讯作者：
Coast J
中科院分区：
文献类型：
--
作者：
Flynn TN;Louviere JJ;Peters TJ;Coast J
通过最佳-最差选择任务补充离散选择实验，可以获得对患者偏好的更多见解。然而，没有实证研究说明在随机效用框架内的各种分析方法的相对优势。多项式和加权最小二乘回归模型估计的离散选择实验。离散选择实验纳入了最佳-最差研究，并在英国NHS皮肤病学背景下进行。在16个假设的预约中，等待时间、医生的专业知识、就诊的便利性和感知的护理彻底性各不相同。估计所有模型的样本水平偏好，并使用协变量调整的多项式logistic回归研究患者亚组之间的差异。配对模型（理论上与“maxdiff”选择模型一致）和边际模型（仅是近似模型）的结果之间存在高度一致性。调整协变量显示，在前一周感觉特别受皮肤状况影响的患者表现出对短/无等待时间的极端偏好，并且不太关心预约的其他方面。受教育程度越高，所有属性水平之间的效用差异就越大，尽管属性本身对选择的影响与受教育程度较低的属性相同。该研究还证明了使用加权最小二乘法的汇总分析与多项模型估计值之间的高度一致性。稳健的政策相关信息的偏好，可以从离散选择实验中获得最好的最坏的问题，相对较小的样本量。由于属性的影响，从潜在效用量表上的水平的位置的分离的效果是不可能使用传统的离散选择实验。这种分离是重要的，因为改变卫生保健中属性水平的卫生政策可能与旨在改变属性影响本身的卫生政策非常不同。汇总分析与多项模型的良好近似是一个有用的发现，因为加权最小二乘选择总数可以更好地了解选择模型，并促进对偏好数据的更熟悉。
Additional insights into patient preferences can be gained by supplementing discrete choice experiments with best-worst choice tasks. However, there are no empirical studies illustrating the relative advantages of the various methods of analysis within a random utility framework. Multinomial and weighted least squares regression models were estimated for a discrete choice experiment. The discrete choice experiment incorporated a best-worst study and was conducted in a UK NHS dermatology context. Waiting time, expertise of doctor, convenience of attending and perceived thoroughness of care were varied across 16 hypothetical appointments. Sample level preferences were estimated for all models and differences between patient subgroups were investigated using covariate-adjusted multinomial logistic regression. A high level of agreement was observed between results from the paired model (which is theoretically consistent with the 'maxdiff' choice model) and the marginal model (which is only an approximation to it). Adjusting for covariates showed that patients who felt particularly affected by their skin condition during the previous week displayed extreme preference for short/no waiting time and were less concerned about other aspects of the appointment. Higher levels of educational attainment were associated with larger differences in utility between the levels of all attributes, although the attributes per se had the same impact upon choices as those with lower levels of attainment. The study also demonstrated the high levels of agreement between summary analyses using weighted least squares and estimates from multinomial models. Robust policy-relevant information on preferences can be obtained from discrete choice experiments incorporating best-worst questions with relatively small sample sizes. The separation of the effects due to attribute impact from the position of levels on the latent utility scale is not possible using traditional discrete choice experiments. This separation is important because health policies to change the levels of attributes in health care may be very different from those aiming to change the attribute impact per se. The good approximation of summary analyses to the multinomial model is a useful finding, because weighted least squares choice totals give better insights into the choice model and promote greater familiarity with the preference data.
登录
查看更多内容
影响因子：
5.4
作者：
Lancsar, Emily;Louviere, Jordan;Flynn, Terry
通讯作者：
Flynn, Terry
影响因子：
7.2
作者：
Louviere, JJ
通讯作者：
Louviere, JJ
影响因子：
2.1
作者：
Bech, M;Gyrd-Hansen, D
通讯作者：
Gyrd-Hansen, D
影响因子：
7.8
作者：
FINN, A;LOUVIERE, JJ
通讯作者：
LOUVIERE, JJ
影响因子：
1.8
作者：
YELLOTT, JI
通讯作者：
YELLOTT, JI